Functional food and drink products should utilise non-nutritive artificial sweeteners as a means to help consumers aid weight management and reduce the risk of diabetes, say scientists.

The new review – published in Current Opinion in Clinical Nutrition & Metabolic Care – suggests that artificial sweetener compounds can and should be used by functional food manufacturers in order to reduce the calorific value of foods and aid weight management in food and beverage products that may already confer other health benefits.

Led by Anne Raben from the University of Copenhagen, Denmark, the researchers argue that considering ‘the prevailing diabesity (obesity and diabetes) epidemic’, the use of non-nutritive sweeteners can be “an important alternative to natural, calorie-containing sweeteners.”

The reviewers noted that intakes of sugars like sucrose and fructose have been linked to the development of lipid dysregulation, visceral adiposity, hypertension, inflammation, metabolic syndrome, type-2 diabetes, and clinical coronary heart disease.

“On the contrary, data from recent longer term intervention studies point toward a beneficial effect of artificial sweeteners on energy intake, body weight, liver fat, fasting and postprandial glycemia, insulinemia, and lipidemia compared with sugars,” said Raben and her colleagues.

“Artificial sweeteners, especially in beverages, can be a useful aid to maintain reduced energy intake and body weight and decrease risk of type-2 diabetes and CVD compared with sugars,” they added.

Hunger and weight gain

Last week, newly published animal data
suggested consumption of non-nutritive sweeteners could actually be linked to weight gain, rather than weight loss. The study in rats found that those fed with non-nutritive sweeteners gained more weight than those fed sugar, despite similar caloric intakes.

However, the reviewers note that the majority of intervention studies indicate that artificial sweeteners do not stimulate hunger or appetite as compared with sucrose.

“Longer term intervention studies ... indicate that artificial sweeteners do not increase energy intake, body weight, ectopic fat accumulation, glycemia, insulinemia or lipidemia as observed with sucrose intake, but rather possess metabolic effects similar to water,” wrote Raben and her colleagues.

As a result, she said recent population data instead point toward decreased body weight and lower risk of type-2 diabetes and CHDs with increased intake of artificial sweeteners compared with sugar.

Natural and zero calorie?

The reviewers noted the growing interest in stevia – a natural non-calorific sweetener obtained from the leaves of the plant Stevia rebaudiana.

Stevioside has 200–300 times the sweetness profile of sucrose, is not metabolized in the body, and has been used as a non-caloric sweetener for many years in various parts of the world, said the authors.

However, they noted that more comprehensive clinical studies concerning stevia are still lacking.

“Recent acute investigations in humans indicate that stevia has similar effects as compared with the more common artificial sweeteners, aspartame, on appetite and energy intake,” they added. “Thus, both stevia and aspartame reduced the total energy intake as compared with sucrose.”

Raben and her team suggest that stevia products “seem to have a great potential as a noncaloric sweetener, maybe particularly in sub-groups such as in diabetic patients.”

“Still, more long-term clinical studies are needed to identify the specific advantages as compared with other artificial sweeteners.”